Diagnosis and treatment of hepatic angiomyolipoma in 26 cases

Ren, Ning; Qin, Lun‐Xiu; Tang, Zhao–You; Wu, Zhi‐Quan; Fan, Jian‐Gao

doi:10.3748/wjg.v9.i8.1856

Cited by 83 publications

(66 citation statements)

References 14 publications

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“…2B tumor. Recently, Ren et al reported that MRI showed hypointensity or hyperintensity on T1-weighted images and heterogeneous hyperintensity on T2-weighted images [14]. In our case, MRI clearly demonstrated a tumor in the subcutaneous region with low signal intensities and well enhanced on T1-weighted images and high signal intensities on T2-weighted images.…”

Section: Discussionsupporting

confidence: 47%

Angiomyolipoma in the Knee-A Case Report

Hatori

Watanabe

Kokubun

2005

Upsala Journal of Medical Sciences

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Extrarenal angiomyolipoma is an uncommon disease and this may be the first report of angiomyolipoma in the knee, mimicking a malignant sarcoma. A 38-year-old man without tuberous sclerosis presented with a history of increased mass in the knee joint. Computerized tomography and magnetic resonance imaging demonstrated a ÇS x ÇS x ÇR cm subcutaneous tumor in the knee joint. The tumor was widely excised. Histologically, the tumor was, well circumscribed, and composed of smooth muscle, vascular spaces, connective tissue, and mature fat. There were no signs of recurrence at one year and eight months after surgery.

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Section: Discussionsupporting

confidence: 47%

Angiomyolipoma in the Knee-A Case Report

Hatori

Watanabe

Kokubun

2005

Upsala Journal of Medical Sciences

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“…The advent of the second-generation ultrasound contrast agents and contrast-specific ultrasound techniques allows depiction of the micro-and macrocirculation of FLLs, which has facilitated a great improvement in the characterisation of FLLs [5,6]. However, until now, few reports in the literature have described the use of contrast-enhanced ultrasound (CEUS) in hepatic AML [7][8][9][10][11]. Herein we analyse retrospectively the imaging features of 12 hepatic AMLs on CEUS; the diagnostic results of BUS and CEUS before pathological examination are also recorded.…”

mentioning

confidence: 99%

Imaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound

Wang

Xu²,

Xie³

et al. 2010

BJR

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ABSTRACT. The aim of this study was to evaluate the imaging features of hepatic angiomyolipoma (AML) on contrast-enhanced ultrasound (CEUS). The imaging features of 12 pathologically proven hepatic AML lesions in 10 patients who had undergone baseline ultrasound (BUS) and CEUS examinations were evaluated retrospectively. The enhancement extent, pattern and dynamic change, along with the enhancement process, on CEUS were analysed. The diagnostic results of BUS and CEUS before pathological examination were also recorded. The results showed that 75% (9/12) of the AML lesions exhibited mixed echogenicity on BUS and most showed remarkable hyperechogenicity in combination with a hypoechoic or anechoic portion. Arterial flow signals were detected in 75% (9/12) of the lesions on colour Doppler imaging. On CEUS, 66.7% (n58) of the 12 lesions exhibited hyperenhancement in the arterial phase, slight hyperenhancement (n52) or isoenhancement (n56) in the portal phase, and slight hyperenhancement (n51) or isoenhancement (n57) in the late phase. Three (25%) lesions exhibited hyperenhancement in the arterial phase and hypoenhancement in both portal and late phases. One (8.3%) lesion exhibited hypoenhancement throughout the CEUS process. Before pathological examination with BUS, only 3 (25%) lesions were correctly diagnosed as hepatic AML. Conversely, on CEUS, correct diagnoses were made for 66.8% (8/12) of hepatic AMLs. Therefore, arterial hyperenhancement and subsequent sustained enhancement on CEUS were found in the majority of hepatic AMLs. The combination of BUS and CEUS leads to the correct diagnosis in the majority of hepatic AMLs, and is higher than the success rate achieved by BUS alone.

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“…In the present patient, hepatic EAML showed homogeneous and significantly lower signal intensity at the hepatobiliary phase at 30 min post-Gd-EOB-DTPA injection compared with the normal liver parenchyma. This may be due to the fact that EAML is mainly composed of diffused epithelioid cells with diverse morphologies, containing an abundant sinusoidal vascular network, but lacking normal liver cells; therefore, the rate of the uptake of Gd-EOB-DTPA is lower (8,9). The hepatic EAML in the current study showed a high signal intensity on DWI scans, with a higher ADC value than that of the surrounding normal liver parenchyma.…”

Section: Discussionmentioning

confidence: 74%

“…Patients with hepatic EAML usually have no specific clinical manifestations or physical signs, although with an increase in tumor size, certain patients may exhibit symptoms caused by tumor compression; however, results of all the laboratory examinations are usually negative. The diagnosis of EAML depends on the immunohistochemical examination (9), and the characteristic immunophenotype is dual positive for the expression of melanoma cells and smooth muscle cells, while the epithelial cell marker is negative. HMB45, one of the melanocytic markers, is the most sensitive marker, and SMA is the major marker for smooth muscle cells.…”

Section: Discussionmentioning

confidence: 99%

Gd-EOB-DTPA-enhanced and diffusion-weighted magnetic resonance findings in hepatic epithelioid angiomyolipoma: A case report

et al. 2015

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Abstract. The present study reports a case of histologically proven hepatic epithelioid angiomyolipoma that was evaluated with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging and diffusion-weighted imaging. A 23-year-old female was admitted to the Northern Jiangsu People's Hospital (Yangzhou, Jiangsu, China) due to a 5.6-cm mass in the liver, and a right partial hepatectomy was performed. Magnetic resonance imaging (MRI) revealed a hypointense mass on T1-weighted imaging, and a hyperintense mass on T2-weighted and diffusion-weighted imaging, with a higher apparent diffusion coefficient value compared with normal liver parenchyma. On the dynamic Gd-EOB-DTPA-enhanced MRI scan, the lesion manifested as hypervascular with multiple filiform vessels and a pseudocapsule image, and in the hepatobiliary phase the lesion demonstrated a lack of contrast retention, thus appearing hypointense compared with the background liver. Pre-operatively, EMAL was diagnosed on the basis of these findings in the tumor. The optimum treatment is complete surgical excision and subsequent follow-up. The patient was healthy and free from recurrence at 6 months and 1 year post-surgery. Therefore, knowledge of EAML specific features on dynamic Gd-EOB-DTPA-enhanced and DWI scans may improve the diagnostic accuracy of hypervascular hepatic tumors and may facilitate treatment selection.

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Diagnosis and treatment of hepatic angiomyolipoma in 26 cases

Abstract: Preoperative radiological diagnosis of HAML is possible. The demonstration of intratumoral fat and central vessels is helpful in the diagnosis. HMB45, A103 and SMA are promising markers for pathologic diagnosis of HAML, and surgical resection is effective for the treatment of HAML.

Cited by 83 publications

References 14 publications

Angiomyolipoma in the Knee-A Case Report

Angiomyolipoma in the Knee-A Case Report

Imaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound

Gd-EOB-DTPA-enhanced and diffusion-weighted magnetic resonance findings in hepatic epithelioid angiomyolipoma: A case report

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